Healing the Sick Person: an Existential Approach to the Art and Science of Psychiatry: Nonbeing, the Family and Society

Many, if not most of us are able to get through life without extreme incapacitating episodes of anxiety and despair. Our innate abilities, our determination, the support of family, friends and society are enough that we are able to manage. We take an the reality of nonbeing, of our existential separation in small doses which we overcome and are thus able to grow.

The family and the larger social structure provide us with the opportunity to be cared for and to go on to care for ourselves and others. Religion and secular systems of belief provide us withmoral codes that guide our will in avoiding self-destructive trends. They also offer justification for self- acceptance; we feel we are right in feeling good about ourselves because we have adhered to the code that we see as defining the ultimate good and bad. The family and social stucture provide us with roles and statuses in which we gain a sense of meaning and immortality. In a healthy society the vast majority of members are made significant in their position.

Societies differ in the degree of maturity they ask of the individual. In some, the leader, like Dostoyevski’s Grand Inquisitor, takes on his subject’s guilt. In surrendering the decision- making onto him, they are relieved of the burden of freedom. He alone bears the responsibility. When the leader is deposed, the individual is left incapacitated until a successor is found. In other cultures it is a societal system, a belief or set of rules that takes the anxiety of guilt from the individual. One knows what is right and what is wrong. In acting in the accepted manner one gains self acceptance. But even social and religious systems can crumble. In defense against the possibility of freedom, the individual either becomes fanatical or turns to lawlessness. Acting without self-reflection, he feels a rush of initial pwer which dwindles as his actions bring him to a condition where his choices become ever reduced and he is led to despair. Morality after all is a description of behaviours that increase a person’s freedom. Though seemingly restrictive, moral codes allow for self-discipline which is the ultimate expression of the will; the free-est will is that which can act regardless of the barriers. Morality in this light is a set of standards which heighten power, which bring one increasing freedom. It is also a formula for avoiding hell, avoiding despair.

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